Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 25MA06957000 | NJ |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA06957000 | NJ |
NPI | 1780652990 |
---|---|
Provider Name | Jeffrey Loren Segal |
First Address | New Providence, NJ 07974-1557 |
Second Address | Livingston, NJ 07039-4896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
562480070 | (05) | NJ |
H71262 | (02) | NJ |